Lung Cancer

SS 26 - Lung 3 - Toxicity

189 - Local Ablative Therapy Improves Survival in Patients with Synchronous Oligometastatic NSCLC Harboring EGFR Activating Mutation Treated With First-Line EGFR-TKIs

Tuesday, October 23
3:55 PM - 4:05 PM
Location: Room 007 C/D

Local Ablative Therapy Improves Survival in Patients with Synchronous Oligometastatic NSCLC Harboring EGFR Activating Mutation Treated With First-Line EGFR-TKIs
Q. Xu1, H. Liu2, Y. Xu3, and C. Zhou4; 11. Department of Radiation Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University,, Shanghai, China, 2Department of Radiation Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University,, Shanghai, China, 3Department of Radiation Oncology, Shanghai Pulmonary Hospital, Shanghai, China, 4Department of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China

Purpose/Objective(s): The aim of the current study was to investigate whether consolidation local ablative therapy (LAT) can improve the survival of patients with stage IV EGFR-mutant NSCLC who have oligometastatic disease treated with first-line EGFR-TKI therapy.

Materials/Methods: Patients with stage IV EGFR-mutant NSCLC and no more than five metastases at diagnosis in 2 months were enrolled. All patients were treated with first-line EGFR-TKIs. Consolidation LAT included radiation therapy or surgery. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan-Meier curves.

Results: From October 2010 to May 2016, 145 patients were enrolled, including 51 (35.2%) who received consolidation LAT to all oligometastatic sites (All-LAT group), 55 (37.9%) who received consolidation LAT to either primary tumor or oligometastatic sites (Part-LAT group), and 39 (26.9%) who did not receive any consolidation LAT (Non-LAT group). The median PFS in All-LAT, Part-LAT, and None-LAT group were 20.6 months, 15.6 months, and 13.9 months, respectively (P<0.001). The median OS in All-LAT, Part-LAT, and None-LAT group were 40.9 months, 34.1 months, and 30.8 months, respectively (P<0.001). The difference was significant between All-LAT group and Part-LAT or Non-LAT group but was not significant between Part-LAT and Non-LAT group. The median OS was significantly improved with consolidation LAT for primary tumor (40.5 versus 31.5 months, P<0.001), brain metastases (38.2 versus 29.2 months, P=0.002), adrenal metastases (37.1 versus 29.2 months, P =0.032). Adverse events (Grade≥3) due to radiation therapy included pneumonitis (7.7%) and esophagitis (16.9%).

Conclusion: The current study demonstrated that consolidation LAT to all sites was a feasible option among patients with EGFR-mutant oligometastatic NSCLC during first-line EGFR-TKI treatment, with significantly improved PFS and OS compared with consolidation LAT to partial sites or observation alone.

Author Disclosure: Q. Xu: None. H. Liu: None. C. Zhou: None.

Qinghua Xu, MD

Disclosure:
No relationships to disclose.

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Send Email for Qinghua Xu


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